The purpose of this study was to obtain a clearer description and understanding of out-of-control sexual behavior from those experiencing the problem. In-depth interviews were conducted with 14 adult men who self-identified as having problematic sexual behavior. Study participants identified a range of meanings for their sexual behavior including: satisfying sexual needs, fulfillment of narcissistic needs, desire for human connection, compensation for low self esteem, need for control, reenactment of childhood trauma, avoidance of feelings, and/or coping with sexual identity issues. Of all of these listed, sexual needs were the least cited reason for the problematic sexual behaviors. Thus, sexually addictive behaviors serve different psychological functions and needs. If these factors are seen psychodynamically as repetition compulsions, rather than behaviorally, then the implication for treatment needs to expand beyond the overt sexual behaviors.